Results of a 4-hour endotracheal intubation class for EMT-basics.
OBJECTIVE
In 1994, the Department of Transportation made endotracheal intubation an optional EMT-Basic skill. To data, there have been no studies addressing the ability of this group to learn or perform this skill. We used a standarized mannequin test to perform a prospective evaluation of this intubation skills of basic EMTs immediately after a 4-hour course on endotracheal intubation. We hypothesized that the intubation success rates would be comparable with those of other types of providers newly trained in this skill.


METHODS
Eighty-three EMTS were selected/recruited from four EMS provider agencies. Ninety-six percent of the EMTs were men, and the average age was 38 years; average length of EMT experience was 9.4 years. Training was provided in classes of 6 to 14 persons and included 1 hour of didactic instruction, a 1-hour demonstration of intubation techniques, and 90 minutes of supervised practice with the mannequins in groups of 2 to 4 persons. Testing followed American Heart Association guidelines. Interrater reliability of test criteria was assessed.


RESULTS
Ninety-four percent (95% confidence interval 86% to 98%) of the EMTs passed the examination by intubating the mannequin within 35 seconds within 3 attempts. Of the successful EMTs, 94% succeeded on their first attempt, 3% on their second attempt, and 3% on their third. There were three esophageal intubations; all were detected immediately. Interrater agreement was 100% on the pass/fail decision.


CONCLUSIONS
This 4-hour class trained basic EMTs to perform endotracheal intubation on mannequins with a success rate of 94%. Further research should confirm the ability of EMT-Basics to detect esophageal intubation and address the retention of intubation skills, the applicability of these skills to the field, and the components of this course that were responsible for its success.
Larmon
B
B
University of California at Los Angeles Emergency Medical Center, University of California at Los Angeles School of Medicine, USA. blarmon@mcpo.medctr.ucla.edu
Schriger
D L
DL
Snelling
R
R
Morgan
M T
MT
D000328:Adult; D004634:Emergency Medical Technicians / Q000193:education* / Q000592:standards; D005260:Female; D006801:Humans; D007318:Inservice Training / Q000379:methods; D007442:Intubation, Intratracheal; D008297:Male; D008348:Manikins; D011446:Prospective Studies